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General NPI Number Information
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NPI Number | 1033416326
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Entity Type | Organization
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Legal Business Name | MALDEN CHIROPRACTIC L.L.C.
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Dates
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Enumeration Date | 02/22/2011
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 123 W MAIN ST
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City | MALDEN
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State | MO
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Zip | 63863-2162
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Country | US
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Telephone | 573-276-3892
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Fax | 573-276-3893
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Provider Business Mailing Address
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Address Line | 123 W MAIN ST
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City | MALDEN
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State | MO
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Zip | 63863-2162
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Country | US
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Telephone | 573-276-3892
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Fax | 573-276-3893
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Authorized Official
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Title or Position | OWNER
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Name | KASSANDRA N BROWNING
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Credential | D.C.
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Telephone | 573-778-6915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2010014270
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License Number State | MO
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